[Assessment of imminence of unplanned out-of-hospital deliveries in Guadeloupe: experience of the mobile emergency and resuscitation service of Pointe-à-Pitre]. / Évaluation de l'imminence de l'accouchement inopiné extra-hospitalier en Guadeloupe : expérience du service médical d'urgence et de réanimation de Pointe-à-Pitre.

OBJECTIVES: Medical tools to determine the imminence of unplanned out-of-hospital birth have not been validated. The main goal of this study was to analyze assessments of the imminence of these deliveries, by methods such as the Manilas score and the need to push. PATIENTS AND METHODS: All calls made to the Emergency Medical Aid Service in Guadeloupe concerning risks of unplanned delivery between January 1st and June 30th 2011 were reviewed retrospectively, and 69 of the 85 cases cared for by the hospital mobile emergency unit were included. RESULTS: Risks of unplanned out-of-hospital deliveries represented 1.9% of the calls during the study period. The Malinas score was used for dispatching in only 13% and was not used for intervention in any case. It was estimated that the need-to-push feeling was used for 58% (dispatching) and 54.5% (intervention) of patients. Its sensitivity, specificity and predictive values were higher than those of the Malinas score in dispatching and substantially higher in intervention. CONCLUSION: These results argue for the development of tools for estimating the imminence of unplanned delivery. Such tools should be applicable in extra-hospital emergency situations to ensure their use in practice.

[Pregnancies among underage girls in Guadeloupe: a new inventory]. / Grossesses évolutives chez les mineures en Guadeloupe : nouvel état des lieux.

OBJECTIVES: In Guadeloupe (French West Indies), fecondity rate of teenagers is higher than in mainland France. The aim of our study was to analyze sociodemographic characteristics and perinatal indicators among underage girls and to compare them to those of a previous study also conducted in our maternity unit in 1993 and 1994. MATERIALS AND METHODS: The sociodemographic, medical, obstetrical and neonatal data of 163 underage pregnant girls delivered from 2009 to 2010 at the University hospital of Pointe-à-Pitre/Abymes were collected retrospectively and compared with the previous study. RESULTS: In 16 years, in contrast to perinatal indicators, which did not significantly evolve, the sociodemographic characteristics of this population have changed. In addition, the increase of neonatal morbidity seems to be related to late initiation of obstetrical care, which also still remains insufficient. CONCLUSION: Our results are close to those described in the other French regions and have hardly evolved since our previous study. The differences found for the obstetric and perinatal risks seem to be related to sociodemographic factors surrounding these underage pregnancies. Those factors should be taken into consideration in any approach aiming to reduce incidence and prevent complications of pregnancies among teenagers.

Health communication and consumer behavior on meat in Belgium: from BSE until dioxin.

This article focuses on the impact of mass media meat-health information on consumer perception, attitude, and behavior toward fresh meat in Belgium. In a situation similar to that which occurred in most other European countries, Belgian fresh meat consumption fell considerably during 1995-1999. A multitude of messages linking meat consumption to human health risks were reported by mass media. Bovine Spongiform Encephalopathy (BSE) since 1996 and dioxin in 1999 constituted the major issues. Empirical research, conducted in April 1998, revealed the tremendous negative impact of mass media coverage of meat-health issues on consumer risk perception, health concern, and attitude and behavior toward fresh meat. Oppositely, personal communication through butchers had only a small effect on consumer decision-making in this era dominated by alarming meat-health press. Implications are threefold. First, mass media should be aware of its social responsibilities, which include spreading reliable and correct information to the society. This is especially the case as human health risks are involved. Second, the meat industry urgently needs to reorient itself toward quality, safety, and transparency. Finally, future communication dealing with similar crises situations requires cooperation across the meat chain, government, and those who are responsible for public health promotion and communication.